联合认知训练和非侵入性脑刺激对成年人群冲动性的调节作用：现有研究的系统评价和荟萃分析
The use of combined cognitive training and non-invasive brain stimulation to modulate impulsivity in adult populations: a systematic review and meta-analysis of existing studies.
作者信息
Khalifa Najat R, Alabdulhadi Yousef, Vazquez Pilar, Wun Charlotte, Zhang Peng
机构信息
Department of Psychiatry, Queen's University, Kingston, ON, Canada.
Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
出版信息
Front Psychiatry. 2024 Dec 9;15:1510295. doi: 10.3389/fpsyt.2024.1510295. eCollection 2024.
INTRODUCTION
Impulsivity, a tendency to act rashly and without forethought, is a core feature of many mental disorders that has been implicated in suicidality and offending behaviours. While research supports the use of non-invasive brain stimulation (NIBS) techniques, such as transcranial direct current stimulation (tDCS), to modulate brain functions, no studies specifically reviewed the use of combined cognitive training and NIBS to modulate impulsivity.
METHODS
We aimed to conduct a systematic review and meta-analysis to synthesise the literature on the use of combined cognitive training and NIBS to modulate impulsivity and its subdomains (motor, delay discounting, reflection). We searched Scopus, PsychInfo, Medline, and Cinahl electronic databases, dissertations database, and Google scholar up to September 2024.
RESULTS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four randomised controlled studies involving the use of combined cognitive training and tDCS in 127 subjects were included in the study. These studies included subjects with substance use disorders, obesity, and Parkinson's disease. Meta-analysis showed that combined cognitive training and tDCS had no statistically significant effects on motor impulsivity as measured using reaction times on the Stop Signal Task and Go/No Go tasks. One study that measured impulsiveness scores on a delay discounting task also showed no significant results. No studies measured reflection or cognitive impulsivity.
DISCUSSION
There is a dearth of literature on the use of combined cognitive training and NIBS for impulsivity. This in conjunction of clinical heterogeneity across studies makes it difficult to draw definitive conclusions about the neuromodulation of impulsivity and its subdomains using combined cognitive training and NIBS. The findings of this study highlight the need to conduct more studies in the field.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD 42024511576.
引言
冲动性是一种未经深思熟虑就贸然行动的倾向，是许多精神障碍的核心特征，与自杀行为和犯罪行为有关。虽然研究支持使用非侵入性脑刺激（NIBS）技术，如经颅直流电刺激（tDCS）来调节脑功能，但尚无研究专门综述联合认知训练和NIBS来调节冲动性的应用。
方法
我们旨在进行一项系统综述和荟萃分析，以综合关于联合认知训练和NIBS调节冲动性及其子领域（运动、延迟折扣、反思）的文献。我们检索了Scopus、PsychInfo、Medline和Cinahl电子数据库、学位论文数据库以及截至2024年9月的谷歌学术。
结果
按照系统综述和荟萃分析的首选报告项目（PRISMA）指南，该研究纳入了四项随机对照研究，涉及127名受试者联合使用认知训练和tDCS。这些研究包括患有物质使用障碍、肥胖症和帕金森病的受试者。荟萃分析表明，联合认知训练和tDCS对使用停止信号任务和Go/No Go任务中的反应时间所测量的运动冲动性没有统计学上的显著影响。一项在延迟折扣任务上测量冲动性得分的研究也未显示出显著结果。没有研究测量反思或认知冲动性。
讨论
关于联合认知训练和NIBS用于冲动性的文献匮乏。这与研究之间的临床异质性相结合，使得难以就使用联合认知训练和NIBS对冲动性及其子领域进行神经调节得出明确结论。本研究结果凸显了在该领域开展更多研究的必要性。
系统综述注册
https://www.crd.york.ac.uk/prospero/，标识符CRD 42024511576。
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